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Pediatrics > Pediatric Pulmonology > Flashcards

Pediatric Pulmonology Flashcards

1
Q

What are the components of CHARGE syndrome?

A
  1. Coloboma of the eye
  2. Heart defect
  3. Atresia choanae
  4. Retarded groth and development or CNS abnormality
  5. Genital anomalies or hypogonadism
  6. Ear anomalies
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2
Q

[Diagnosis]

4/M
High fever
Sore throat
Drooling, neck slightly hyperextended

A

Acute epiglotittis

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3
Q

[Diagnosis]

3mos to 3 years
Stridor
Low grade fever
1-7 days prodrome
barking cough
hoarseness

responds to racemic epi

A

Viral Croup

Parainfluenza virus

CXR: Steeple Sign

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4
Q

[Diagnosis]

3-7 years
Onset is rapid (4-12 hours)
High grade fever
muffled voice, drooling

A

Epiglottitis

H. influenzae type B

CXR: Thumb sign/ leaf sign

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5
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

prominent itching and sneezing, nasal eosinophilia

A

Allergic Rhinitis

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6
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

unilateral foul smelling discharge, bloody nasal secretion

A

Foreign body in the nose

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7
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

Headache, facial pain, periorbital edema, rhinorrhea for >2 weeks

A

Sinusitis

Co-amoxiclav x 14 days

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8
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

persistent rhinorrhea with onset in the first 3 months of life (snuffles)

A

congenital syphilis

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9
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

history of prolonged use of topical or oral decongestant

A

Rhinitis medicamentosa

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10
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

Paroxysm of cough leaving the baby breathless and subconjunctival hemorrhages

A

Pertussis or whooping cough

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11
Q

Most common cause of sinusitis (organism)

A
  1. S. pneumoniae
  2. Non-typable H. influenzae
  3. M. catarrhalis
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12
Q

Sinuses present at birth

A
  1. Maxillary

2. Ethmoid

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13
Q

Sinuses that are pneumatized at 4 years old

A

Sphenoid

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14
Q

Sinuses that begin to develop at 7-8 years old

A

Frontal

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15
Q

What are the stages of pertussis?

A
  1. Catarrhal
  2. Paroxysmal
  3. Convalescent
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16
Q

What is the DOC for pertussis?

A

Macrolide (Erythromycin or Clarithromycin)

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17
Q

What is the period of communicability in pertussis?

A

From 7 days after exposure to 4 weeks after onset of typical paroxysms

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18
Q

What is the most common complication of acute nasopharyngitis?

A

Otitis media

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19
Q

When will you consider doing tonsillectomy in patients with recurrent strep pharyngitis?

A
  1. > 7 episodes in the previous year

2. >5 in each of the preceding 2 years

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20
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

patchy and ragged tracheal column

A

bacterial tracheitis

Tx: Antibiotics

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21
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

thumb sign

A

Acute epiglottitis

If vaccinated: S. aureus

In unvaccinated: Hib

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22
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

subglottic narrowing

A

Croup or laryngotracheobronchitis

All levels of distress: Dexamethasone

Moderate to severe distress: Steroid + racemic epinephrine

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23
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

Air trapping on the right lung with mediastinal shift towards the right lung

A

Foreign body airway obstruction

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24
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

steeple sign

A

Croup of LTB

ll levels of distress: Dexamethasone

Moderate to severe distress: Steroid + racemic epinephrine

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25
Q

[Classify asthma severity]

Daytime symptoms: <1x/week
Nighttime symptoms: <2x/month
PEFR: >80%
PEFR Variability: <20%
FEV1: >80%
A

Intermittent

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26
Q

[Classify asthma severity]

Daytime symptoms: >1x/week
Nighttime symptoms: >2x/month
PEFR: >80% predicted
PEFR Variability: 20-30%
FEV1: >80%
A

Mild

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27
Q

[Classify asthma severity]

Daytime symptoms: Affects daily activities
Nighttime symptoms: > 1x/week
PEFR: 60-79%
PEFR Variability: >30%
FEV1: 60-79%
A

Moderate

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28
Q

[Classify asthma severity]

Daytime symptoms: Limits daily activities
Nighttime symptoms: >1x/week
PEFR: <60%
PEFR Variability: >30%
FEV1: <60%
A

Severe

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29
Q

[Levels of asthma control]

Daytime symptoms: >2x/week
Nighttime symptoms: Any
Limitation of activities: none
Reliever: >2x/week
PEF or FEV1: <80%
Exacerbation: one or more /year 1 in any week
A

Partly controlled

Uncontrolled if 3 or more features of partly controlled asthma

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30
Q

[Diagnosis]

patient is wheezing

history of viral infection among family members. Patient is 2 years old.

A

Bronchiolitis

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31
Q

[Diagnosis]

patient is wheezing

Hx of atopy in the family. recurrent wheezing after mild viral infection or after exercise.

A

Bronchial asthma

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32
Q

[Diagnosis]

patient is wheezing

Wheeze heard loudest over the trachea. persistent wheezing never seems to go away.

A

Chondromalacia

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33
Q

[Diagnosis]

patient is wheezing

Absent breath sounds on the right lung. Patient is 3 y/o

A

Foreign body airway obstruction

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34
Q

[Diagnosis]

Fever, cough, tachycardia

Poorly nourished, unvaccinated with onset of rashes all over the body

A

Measles pneumonia

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35
Q

[Diagnosis]

Fever, cough, tachycardia

Patient has cystic fibrosis, or a CGD, burn patient, neutropenic

A

Pseudomonas

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36
Q

[Diagnosis]

Fever, cough, tachycardia

Patient is a teen, living in a dormitory, initial cough is non-productive

A

Mycoplasma

37
Q

[Diagnosis]

Fever, cough, tachycardia

patient has his own aviarium in his home

A

Psittacocis

38
Q

[Diagnosis]

Fever, cough, tachycardia

Eye discharge during the first 5-14 days of neonatal period

A

Chlamydia

39
Q

[Diagnosis]

Fever, cough, tachycardia

extensive areas of hemorrhagic necrosis, irregular areas of cavitation, pneumatoceles, empyema, bronchopulmonary fistula

A

S. aureus

40
Q

[Diagnosis]

Fever, cough, tachycardia

Diffuse infection with interstitial pneumonia, necrosis of tracheobronchial mucosa formation of large amounts of exudates, edema, local hemorrhage

lymphatic vessels included

A

GABHS

41
Q

[Diagnosis]

Fever, cough, tachycardia

local edema that aids in the proliferation of organism resulting in focal lobar involvement

A

Pneumococcus

42
Q

[Diagnosis]

Fever, cough, colds, wheezing stridor, tachycardia

CXR: lobar consolidation

A

Pneumococcus

43
Q

[Diagnosis]

Fever, cough, colds, wheezing stridor, tachycardia

CXR: hyperinflation with bilateral interstitial infiltrates and peribronchial cuffing

A

RSV

44
Q

[Diagnosis]

Fever, cough, colds, wheezing stridor, tachycardia

CXR: Prominent areas of cavitation and multiple pneumatoceles

A

Staphylococcus

45
Q

[Diagnosis]

Fever, cough, colds, wheezing stridor, tachycardia

CXR: right sided hilar adenopathy

A

Mycobacterium tuberculosis

46
Q

[Diagnosis]

High fever, in distress, acutely ill, brassy cough, copious purulent sputum

CXR: Ragged air column sign / pseudomembrane detachment in the trachea

A

bacterial tracheitis

47
Q

[Types of Cough]

Staccato

A

Chlamydia

48
Q

[Types of Cough]

Brassy

A

Staphylococcus

49
Q

[Types of Cough]

Barking seal

A

Parainfluenza

50
Q

[Types of Cough]

Whooping posttussive vomiting

A

Bordetella

51
Q

[Types of Cough]

Most severe in the morning

A

Asthma

52
Q

[Types of Cough]

With vigorous exercise

A

Exercise-induced asthma

53
Q

[Types of Cough]

Disappears with sleep

A

Habit cough

54
Q

[Types of Cough]

Tight sounding with wheezing

A

Asthma

55
Q

What is the primary site of obstruction in Acute Infectious Laryngitis?

A

Subglottic area

56
Q

Tuberculin sensitivity develops ___ after its administration on the forearm

A

72 hours

57
Q

[TB classification]

(+) exposure
(-) PPD

A

TB exposure

58
Q

[TB classification]

(+) exposure
(+) PPD

A

TB infection

59
Q

[TB classification]

What are the criteria ti diagnose TB disease

A

3 or more of

  1. Exposure
  2. (+) PPD
  3. SSx suggestive of TB
  4. Abnormal chest xray findings
  5. Lab findings
60
Q

[PPD interpretation]

> 10mm
no exposure

A

Postive

61
Q

[PPD interpretation]

> 5mm with close contact to known case, clinically suggestive of TB, CXR findingssuggestiv of TB, ICC

A

Positive

62
Q

[TB Medications]

What is the dose of INH

A

10mg/kg/day PO

63
Q

[TB Medications]

What is the dose of Rfampicin

A

15mg/kg/day PO

64
Q

[TB Medications]

What is the dose of pyrazinamide

A

25mg/kg/day

65
Q

[TB Medications]

what is the dose of ethambutol

A

15mg/kg/day

66
Q

[TB Medications]

What is the dose of streptomycin

A

Im 20-40mg IM OD

67
Q

[DOH TB Treatment Regimens]

Cat I

A

2HRZE

4HR

68
Q

[DOH TB Treatment Regimens]

Cat Ia

A

2HRZE

10HR

69
Q

[DOH TB Treatment Regimens]

Cat II

A

2HRZES
1HRZE
5HRE

70
Q

[DOH TB Treatment Regimens]

Cat III

A

2HRZES
1HRZE
9HRE

71
Q

[Discontinuing TB medications]

When will you discontinue INH and RIF

A
  1. ALT/AST is more that 3-5x the normal values
72
Q

What are the indicators for pneumonia in a 3 month to 5 years old?

A

Tachypnea or retractions

73
Q

What are the indicators for pneumonia in 5 to 12 years old?

A
  1. Fever
  2. tachypnea
  3. crackles
74
Q

[Etiology of pneumonia]

0-28 days

A
  1. E. coli
  2. Listeria
  3. S. pneumoniae
75
Q

[Etiology of pneumonia]

3 weeks to 3 months

A
  1. RSV
  2. Parainfluenzae
  3. Chlamydia
  4. Mycoplasma
  5. S. pneumoniae
76
Q

[Etiology of pneumonia]

4months to 5 years old

A
  1. Viruses
  2. S. pneumoniae
  3. H. influenzae type B
  4. Mycoplasma
77
Q

[Etiology of pneumonia]

5 to 15 years old

A
  1. Mycoplasma

2. S. pneumoniae

78
Q

[Drugs for pCAP]

DOC for pCAP A and B

A

Oral amoxicillin

79
Q

[Drugs for pCAP]

DOC for pCAP C, no previous antibiotic use, complete HiB

A

Penicillin G

80
Q

[Classify pneumonia]

Dehydration: mild
Malnutrition: none
Pallor: none

Retraction: none
Head bobbing: none
Cyanosis: none
Grunting: none
Apnea: none
Sensorium: none
A

pCAP B

81
Q

[Classify pneumonia]

Dehydration: moderate
Malnutrition: moderate
Pallor: present

Retraction: IC/subcostal
Head bobbing: present
Cyanosis: present
Grunting: none
Apnea: none
Sensorium: irritable
A

pCAP C

Admit to ward

82
Q

[Classify pneumonia]

Dehydration: severe
Malnutrition: severe
Pallor: severe

Retraction: supraclavicular
Head bobbing: present
Cyanosis: present
Grunting: present
Apnea: present
Sensorium: lethargic/stuporous
A

pCAP D

Admit to ICU

83
Q

[Classify pneumonia]

Cough wheezing, stridor,

CXR: diffuse, streaky infiltrates

CBC: Lymphocytosis

A

Viral

84
Q

[Classify pneumonia]

Cough, high fever, dyspnea, dullness to percussion

CXR: lobar pneumonia

CBC: neutrophilia

A

Bacterial

Tx:

  1. If 0-2 mos Ampicillin + Aminoglycosides
  2. If 2mos-5years Ceftriaxone or Cefuroxime + Ampicillin or Amoxiclav
85
Q

[Classify pneumonia]

Less ill-looking, non-productive cough

CXR: Interstitial pattern, lower lobes

A

Mycoplasma

Tx:
1. If >5 years old, Erythromycin, Clarithromycin, Azithromycin

86
Q

[Classify pneumonia]

6 weeks to 6 months old
Staccato cough
maternal history of infection

CXR: hyperinflation, ground glass appearance

CBC: eosinophilia

A

Erythromycin PO x 14 days

87
Q

Most common etiology of peritonsillar abscess

A

GAS and anaerobes

88
Q

[Diagnosis]

3-4 years old; M>F

Drooling, neck held in hyperextension, bulging of the posterior pharyngeal wall, neck pain, muffled voice, respiratory distress

A

Retropharyngeal abscess

Tx:

  1. 3rd gen cephalosporin with Ampicillin-Sulbactam OR Clindamycin

Pediatrics (15 decks)

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